Multiple coronary occlusions associated with ST-segment elevation

We describe the case of a patient with rapid sequential ST-segment elevation in different areas on the electrocardiogram (ECG) associated with lesions of differing etiologies in the corresponding coronary arteries. Prior reports of ST-segment elevations in multiple areas on the ECG have been from obstructions of single coronary vessels whose distribution overlapped separate areas on the ECG or spasm of multiple coronary arteries. We could find no prior reports of such rapid sequential ST-elevation in different areas on the ECG caused by two differing etiologies.